Dimensional Symptom Severity

1. Pamela DeRosse a,b,c,
⁎, George C. Nitzburg b,c,d
, Melanie Blair b,c,e
, Anil K. Malhotra a,b,c
a
Hofstra-Northwell School of Medicine, Department of Psychiatry, Hempstead, NY, USA b
Center for
Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
c
Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, NY,
USA d
Teachers College, Columbia University, New York, NY, USA
e
Graduate Center, City University of New York, New York, NY, USA
a r t i c l e i n f o a b s t r a c t
Article history:
Received 12 June 2017
Received in revised form 23 August 2017
Accepted 9 October 2017
Available online 19 October 2017
Over the last several decades Quality of Life (QoL) has become increasingly important as an indicator of treatment outcomes;
particularly in schizophrenia spectrum disorders because of its close association with functional disability. Numerous studies
seeking to elucidate the factors that contribute to QoL in this population have implicated both symptom severity and cognition
in determining QoL but the findings have been mixed. The critical factors that appear to impede the lack of consensus in the
extant literature examining determinants of QoL in-
1. Introduction
Quality of Life (QoL) is a multidimensional construct encompassing an
individual's perception of their position in life in relation to their culture,
goals, expectations, standards and concerns (WHOQOL-Group, 1995). Over
the last several decades QoL has become increasingly important as an
indicator of treatment outcomes over a wide range of health and disease states.
This interest in QoL as an outcome measure has been particularly pronounced
in schizophrenia spectrum disorders (SZ) because of its close association with
functional disability; a critical problem for patients with these disorders
(Lieberman et al., 2008; Malla and Payne, 2005).
To date, numerous studies of people with SZ have implicated general
psychopathology such as anxiety and depressive symptoms (Dickerson
⁎ Correspondence to: P. DeRosse, The Zucker Hillside Hospital, Northwell Health, 75-59 263rd
Street, Glen Oaks, NY 11004, USA.
E-mail address: pderosse@northwell.edu (P. DeRosse).
https://doi.org/10.1016/j.schres.2017.10.018 0920-9964/©
2017 Elsevier B.V. All rights reserved.
et al., 1998; Huppert et al., 2001; Narvaez et al., 2008; Reine et al., 2003) as well
as the more specific domains of positive and negative symptoms (Fitzgerald et
al., 2001; Norman et al., 2000; Savill et al., 2016) in determining QoL. A recent
meta-analysis (Eack and Newhill, 2007) examining the relative contribution of
psychiatric symptoms to QoL found that these symptoms have a significant, but
small, negative relationship with QoL in patients with SZ. However, these
authors acknowledged that their results were limited by the heterogeneity among
the samples included noting that sample characteristics such as treatment setting
Keywords:
Quality of life
QoL
Cognition
Negative symptoms
Depression
MCCB
clude the heterogeneity of the samples and measures examined as well as medication effects across different studies. Thus, the
present study sought to address some of these issues by examining the relationship between subjective QoL and both symptom
severity and cognitive function in a relatively homogeneous patient sample of patients and a community control sample assessed
for dimensional symptom severity. Our results suggest that both global cognitive function and psychiatric symptoms have a
significant impact on the subjective QoL of both people with schizophrenia spectrum disorders and psychiatrically healthy
adults. Specifically, we found that a global index of cognition as well as self-reported avolitional and depressive symptoms were
significantly predictive of QoL in both samples. These findings highlight the importance of addressing cognitive, depressive
and avolitional symptoms in the treatment of patients with schizophrenia spectrum disorders and suggest that improvements in
these domains may have a meaningful impact on their overall QoL.
© 2017 Elsevier B.V. All rights reserved.

2. 386 P. DeRosse et al. / Schizophrenia Research 195 (2018) 385–390
(inpatient vs. outpatient) and illness stage (first-episode vs. chronic), which were
commonly